Objective Currently, Dural venous sinus stenting (DVSS) has appeared as a prospective therapy for venous hypertension. However, there remains considerable ambiguity over the safety and efficacy of this procedure, in particular, the incidence of intraprocedural and delayed complications and in the durability of sinus patency and satisfactory clinical outcome. The aim of this study was to determine clinical, radiological, and manometric outcomes after DVSS in this cohort.
Methods This is a retrospective case series of venous stenting during the period of Feb 2013 to Jun 2017 at the University of Virginia. The Clinical, radiographic, and manometric data before and after DVSS were reviewed. All venographic and manometric procedures were performed both under local anesthesia and general anesthesia with the patient supine.
Results 125 patients underwent a total of 146 procedures of DVSS. 117 (92.8%) were female, the mean age 32.2±12.4 years with a median BMI of 31±10. The median clinical and radiological follow up are 127 and 90 days. The mean preop gradient is 12.2±11.8 and the post-stent gradients were 1.7±2.6 and the reduction in gradient was achieved in all patients with obliteration of significant anatomical stenosis. At the last follow up clinical improvement noted in 60.8% and needed repeat stenting in 14 patients. The procedural complication rates occurred in 6/125 (4.8%) which includes death in one patient, femoral pseudoaneurysm in 2 and catheter tip fracture in one and contrast extravasation in one and improper stent dislodgement in one. Nonflow limiting in-stent and adjacent stent stenosis noted in 14/125 (11.2%) patients and adjacent stenosis only noted in 4/125 (3.2%) patients.
Conclusions DVSS is one of the alternative modalities of treatment in increased venous pressure which is associated with less number of complications and moderate efficacy. To definitively compare the outcomes between DVSS and other modalities, a randomized prospective study is needed.
Disclosures M. Patibandla: None. C. Chen: None. Y. Kalani: None. M. Park: None. K. Liu: None.
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